Jump to comment:
- Page navigation anchor for RE: The authors respond to Mitchell and WalshRE: The authors respond to Mitchell and Walsh
We thank Drs. Mitchell and Walsh for their response to our article. From a public health perspective, we agree that approaching drug policy from a public health as opposed to legal perspective has the most support in evidence for positive community health outcomes. This has been borne out by Portugal’s experiences and is in line with the declarations of several public health departments such as those issued by Toronto Public Health. (1) With that lens in mind, it is important to note that the commentary does not make any statement that the overall legalization of cannabis as a policy measure is undesirable, nor does it call for any reversal or delay. (2)
Equally important to note, however, that while legalization resolves a whole host of structural determinants that impact health, there are downstream impacts that must be considered in the overall picture. Much like alcohol and tobacco, legal does not mean entirely safe, and the use of cannabis in any form (inhaled, ingested, or otherwise) can present health risks. That our commentary seemingly focuses on the harms of edibles reflects the state of extant literature available to date. The risks of accidental ingestion by at risk groups and overconsumption with cannabis edibles is certainly real and borne out through health services data in other jurisdictions. That the respondents choose to debate aspects of potential contamination of illegally produced edibles does not negate these other risks at all.
Specif...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Narcotics in cannabis edibles? There's no need for naloxone.Narcotics in cannabis edibles? There's no need for naloxone.
Several comprehensive reports, from the Le Dain commission in 1972 to the more recent rounds of debates in the Canadian senate have concluded that the health risks of cannabis prohibition outweigh those of a regulated market. Cannabis legalization requires provisions for edibles, as the absence of edibles in the legal market incentivizes the potentially less healthy practice of inhaling smoke. As such the introduction of a regulated market for cannabis edibles should be reason for celebration among those concerned with a health-based approach to drug policy. However, despite Canada’s innovation and international leadership in cannabis policy the CMAJ editorial marking the introduction of cannabis edibles (Grewal & Loh) focused exclusively on harms, and included an unsupported suggestion that Canadian adults be directed to avoid homemade or illicit edibles.
With regard to the caution on homemade edibles the authors provide no reason to expect that cannabis cuisine is more likely to bear food borne illness than any other home-prepared food. Are Canadians unsafe in their own pantries? More pernicious is the tired canard of narcotic contamination of cannabis. There are reasons to avoid the illegal market, but narcotic contamination is not one of them. As researchers active in the area of cannabis and public health we have not yet encountered any reliable evidence of the contamination of cannabis with opioid narcotics. Indeed, misplaced concern regarding fentany...
Show MoreCompeting Interests: Ian Mitchell has received research support from Tilray licensed producers of cannabis. He has not received any financial compensation for his work in these capacities. He is a clinician at the Cannsolve clinic in Kamloops. He has no financial interest in the clinic. Zach Walsh has received research support from Tilray and DOJA licensed producers of cannabis. He has not received any financial compensation for his work in these capacities. He is also a Medical Advisor to the Indigenous Bloom corporation which seeks to establish opportunities to engage Canadian Indigenous communities in the cannabis industry. He has shares in Indigenous Bloom to compensate for his contributions.